What follows is a typical visit to the physician for back pain in the United States: A person hurts his or her back and sees a doctor for a complete workup. The clinician, careful not to miss anything, orders an MRI that is subsequently read by a distant radiologist. The report is sent back to the physician who, depending on the results, calls for a follow-up appointment to discuss outcomes. It is likely that the patient is sent to a physical therapist, who provides a therapy regimen based on the radiology imaging and his or her own experience without need for the physician’s specific prescription. While much can and has been written about this typical medical experience, from its inefficiency to its reliance on medicalization and overdiagnosis, it is the fragmentation and lack of contextualization that Dr. Patrick Roth has highlighted in his latest work, The Me in Medicine: Reviving the Lost Art of Healing.

With an increasing reliance on technology and the expansion of artificial intelligence in medicine, Dr. Roth paradoxically calls on physicians to embrace their philosophical faculties. He proposes that narratives, developed through introspection, as well as teaching, mentoring, and writing, are the missing components in our medical system today. The onus is on both patients and physicians to develop individual and, when they come together for a clinical encounter, shared narratives on health, disease, and treatment for better overall care.

For the patient, narratives mean coming to understand how he or she views health and disease. As Jerome Groopman explains in his book, Your Medical Mind, and Dr. Roth highlights in his, people have a spectrum of temperaments with regards to intervention: Some believe strongly in the human body’s regenerative capacity (naturalist) and others believe strongly in science, technology, and medicine (technologist). These proclivities are important for the patient to consider when making medical decisions, but only represent one piece of the puzzle.

Patients must also consider unconscious cognitive biases they have when making their decision for treatment. Common cognitive biases include the availability heuristic, a mental shortcut in which a person makes decisions based on readily available examples, and hyperbolic discounting, in which a person discounts future reward because of the time delay between the decision and the reward. For instance, using the availability heuristic, a patient may be hesitant to undergo a procedure because a friend had a similar procedure that did not end well, whereas using hyperbolic discounting, a patient may prefer a procedure because they perceive the reward as immediate as compared with the longer treatment course of physical therapy. While highlighting the patient’s decision-making heuristic is certainly not easy, it serves to both increase patient autonomy and satisfaction with outcomes.

The complexities of these medical decisions is the space where physicians, equipped with their own medical narratives, help the patient decide what is best. The physician has the ability to provide the context necessary for the patient’s choice. For this reason, it is incumbent on the physician to become a good storyteller. It is not enough to lay out all the options with statistics or paternalistically make the decision. Rather, believes Dr. Roth, the physician most effectively communicates through anecdotes and analogies for understanding disease ontology and treatment decisions.

There are a number of tools at the disposal of physicians and patients to accomplish these lofty, yet achievable goals. With honed doctoring skills, the physician can extract the patient’s motivations and contextualize them to reach a sustainable and satisfactory outcome. Further, the physician can foster self-efficacy and promote a deep education about disease. The patient, on the other hand, possesses knowledge that the physician is not privy to, i.e., the phenomenology of the disease. By joining support groups and forming online communities, patients empower themselves and shape the narrative of their needs for the medical community. Engaging in these exercises shapes not only the character of the patient and physician, but the disease process too, as it reforms a patient’s reality through changes in their thoughts and perceptions.

Medical science and technology naturally lend themselves to a reductive materialism with an approach that parses apart reality into molecular cascades and biotargets on which intervention is possible. Analogously, medicine, as a distinctly human endeavor, naturally lends itself to storytelling—the currency of effective communication and change. As such, Dr. Roth makes a formidable case for narratives as a staple of holistic medical practice. Narratives reform environmental context, which in turn shapes us and our health. With technology and specialization playing an ever-expanding role in our healthcare system, it will remain paramount to scrutinize our narratives and ensure they are always in service of our patients. — John Paul Mikhaiel

JP Mikhaiel is a medical student at Georgetown University School of Medicine. After earning his BS in neurobiology and philosophy at Georgetown University, he spent two years at the NIH researching brain-related disorders. He is currently a member of the Literature and Medicine track at Georgetown University, and serves on the management board for the coaching program, A Whole New Doctor. His work has been published in Scope, Georgetown’s literary journal. Mikhaiel plans to pursue a career in neurology.

Though much is taken, much abides: RX: A Graphic Memoir on corporate America and bipolar disorder

RX: A Graphic Memoir by Vermont-based cartoonist Rachel Lindsay is a memoir borne out of passion, determination, and commitment. Each chapter is short and episodic, and provides a chapter in the story of her unraveling: her time committed to a mental health institution and how she got there. Lindsay writes with a wry dark humor about her struggles to maintain stability with bipolar disease while working in a corporate job.

At nineteen, Lindsay was diagnosed with bipolar disease, a mental illness characterized by episodes of mania and depression. Staying sane becomes her primary objective and the medication her psychiatrist prescribes her helps keep her sane. Lindsay describes this rhythm of her sanity in three panels like a mantra: “Chug. Crush. Toss.”

Rachel Lindsay

Lindsay, whose comic strip, “Rachel Lives Here Now,” about her life as a New York transplant in Vermont, appears weekly in Vermont’s statewide alternative newspaper, Seven Days , has created a memoir that serves as a timely narrative for what many are experiencing in the United States. For the author, as with other Americans with pre-existing conditions, her corporate job is a means to an end, providing her with health insurance and prescription medication coverage. Despite feeling unhappy at her work, she continues at her job. She gets a promotion, which means she gets thrust into the corporate pharmaceutical world and works on a marketing campaign for an antidepressant, Lindsay continues to feel even more trapped.

As a graphic memoir, Lindsay’s style is frenzied, a visual staccato beat that moves her narrative along. The lack of gutter space makes the narrative feel overwhelming at times, yet each panel is concise and detailed. Often metaphorical, her chapters begin with a reflexive lens into the story. In one, she appears in a straitjacket. In another, she’s an “urban badass” ripping her way out of wall graffiti to symbolically step on the dead wind-up toy of her in the first chapter, sunglasses on, smoking, and giving the finger.

RX is also a book about a millennial, a millennial with a mental health condition. Trying to find balance between where you are and where you feel you ought to be, I identify well with that feeling. At a party in Brooklyn in 2010, a partygoer says to Lindsay, “Screw your corporate job and really commit yourself to your art. You’re really talented!!” And throughout her memoir, she struggles to find a creative outlet while maintaining her corporate veneer. Quite literally a wolf in one chapter, dressed in sheep’s clothing, she shows us the precariousness of just passing. And its toll on her mental health.

In her interactions with the system, whether this is the healthcare system, the corporate capitalist system, or the criminal justice system, the graphic writer echoes the frustration and hopelessness of feeling trapped. This shapes her story. The day after she is committed, Lindsay sits alone in a cell. “It’s easier to be angry than sad,” she writes. “Despite the psychiatrist I hadn’t stopped seeing, despite the pills I stopped taking, I sat tagged and overmedicated in a new prison – …waiting to be corrected to fit someone else’s definition of sanity.”

The memoir ends with recognition of the system she is beholden to—though much is taken, much abides. She writes with insight from her struggles with sanity and insanity and the work it has taken to get her to today. Lindsay dedicates the book to Burlington, Vermont, where she currently resides. Though her ending feels abrupt—How did she get where she is now? What happened after moving back in with her parents? What headspace is she in now? —Lindsay writes with calmness, reflection, and grace. This book is a testament of her voice.—Jane Zhao

Jane Zhao

Jane Zhao is a lover of comics because when she has no brain or patience for words, she can escape into image. She is a graduate of the Narrative Medicine program at Columbia University and studied neuroscience at McGill University. She currently works in research in Canada. Talk to her about poetry, Donna Haraway, health policy, and muscle pain.

The world of pediatric oncology is one of extremes. The diseases strike unexpectedly, cruelly, and without discernible cause in the midst of childhood, a time of remarkable growth and innocence. While these diseases were once a death sentence, the improvements in survival rates (in places where the latest treatments are available) have been dramatic: five-year survival rates of near 90% compared to 10% just forty years ago. Even so, the burdens of disease and treatments are high, and of course, death still comes too often. Among the tribulations of the pediatric cancers, beauty can be found in the lives and loves of the children and families. One aspect of beauty is the compassionate connections that can develop between the children affected. In The Moon Prince and the Sea, Dr. Daniela Anderson captures this beauty in both words and pictures as she tells a fantasy story based on actual patients.

Sumit is a boy in rural India who travels for days to get to the hospital for treatments for an undefined serious illness. As he physically recovers, he connects with other children in the hospital. He also learns of a girl named Marina in a distant country (the US) who has cancer as evidenced by her bald head and connection to an IV pole. He is touched by her story and dreams of her. He paints her a picture with two moons—one on earth and one in the sky—and sends the picture and a brief letter of encouragement to Marina. Far away, she receives his gifts and feels both connection and comfort.

After he returns to his country home from the city hospital, Sumit is not able to return for more treatments because of the family’s lack of resources. A caring nurse travels to Sumit’s home to find him with hopes of continuing his treatment. The neighbor children, however, inform her that Sumit is now “in God’s home.” But in Anderson’s imagining, the story has not ended and Sumit’s connection to Marina continues.

Back in her hospital, Marina waits until family and friends are ready, and then she closes her eyes and takes her last breath. In the next place, she and Sumit are united, healed, unafraid, and bound together.

Anderson’s watercolor illustrations are rich and vibrant, and they evoke feelings of comfort and compassion. Sumit has a yellow silk cape that both connects him to the moon and presents him with a certain regal dignity and resilience. His cape and bearing mark him as “the moon prince,” while Marina’s name means “the sea,” and thus the book’s title. While Marina is surrounded by family and the best of medical care and resources, there is a sense of vulnerability as her disease puts her beyond all efforts of cure. Understandably frightened, she has a quiet strength as she waits to take her last breath until her family is ready. Hand in hand, Sumit and Marina then travel on together, connected to the mystery of the unknown while rooted in the known, which is love.

Children with cancer and other serious diseases are, of course, like the rest of us—not always saints, not always wise and inspirational. Yet there is something striking about the experience of a life-threatening illness at a time of life wired for dramatically persistent growth. Such children often have and show stubborn resilience and focus their time and attentions more on the prospects of living rather than dying. And if death comes, it is not uncommon that they demonstrate deep compassion for their family and their fellow patients—others who suffer. Anderson captures these aspects of children and illness in the story, which treats death as both ending and beginning. There is real sadness, of course, in the story because it is faithful to the truths of terminal childhood illness. Nevertheless, the strongest feelings and impressions are connection, compassion, and transcendence, and these are other real truths at the intersection of the worlds of childhood and illness. — Greg Adams

Greg Adams, LCSW, ACSW, FT is Program Coordinator for the Center for Good Mourning and Staff Bereavement Support at Arkansas Children’s Hospital in Little Rock, Arkansas. His work of 27 years at Arkansas Children’s Hospital includes time in pediatric oncology, pediatric palliative care, and grief support for staff and community adults, adolescents and children. He also writes and edits a grief/loss electronic newsletter, The Mourning News. Other current related experiences include teaching an annual grief/loss elective class in the University of Arkansas-Little Rock Graduate School of Social Work and chairing the Credentialing Council for the Association of Death Education and Counseling.

Public policies are often determined by three main components: ethics, science, and social considerations. In the 21st century, among calls for ‘personalized medicine,’ few topics raise as much concern as genes, genetic diseases and genetic interventions. Am I My Genes?: Confronting Fate and Family Secrets in the Age of Genetic Testing, a book by psychiatrist and ethicist Robert L. Klitzman, MD., published by Oxford University Press, is timely, providing a valuable insight into the social considerations surrounding genomic medicine.

Dr. Klitzman, who is Professor of Clinical Psychiatry and the Director of the Masters of Bioethics Program at Columbia University, interviewed 64 individuals who were sick, or had an increased risk of being sick, with one of several genetic diseases: Huntington, breast and ovarian cancer, and Alpha-1 antitrypsin deficiency (AAT). He provides an in-depth summary and analysis of the responses, opening a window to the interviewees’ lives, fears and dreams. In particular, the book reports their experiences in the familial context, their understanding of the disease and the science involved, their decision-making processes, and their views regarding relevant social policies. Dr. Klitzman, who is the author of When Doctors Become Patients, A Year-long Night: Tales of a Medical Internship, In a House of Dreams and Glass: Becoming a Psychiatrist, and other works, provides a compelling and entertaining narrative that brings to life the struggles, realizations and often painful process involved in illness.

The reader learns a great deal from the interviews.

First, the interviewees are highly affected—mostly in negative ways—by these diseases. Bonnie, for example, who is at an increased risk of carrying a breast cancer gene, reports being terrified of the prospect of being tested positive. Such result, she claims, would hurt her more than help her, and would make her question her meaning in life (p.45). Others, such as Diane who had to undergo mastectomy, may feel depressed and as if they lost hope and control over their lives because of these genetic diseases (p.154).

Second, coping with these diseases in the medical context raises important ethical and professional issues. For example, as Dr. Klitzman claims, clinicians may be overeager to test for these diseases while ignoring the psychological and ethical considerations. Thus, Betty, suffering from AAT, was negatively surprised that a pediatrician tested her child for AAT without consulting with her first (p.55). Similarly, Laura, a graphic designer, with breast cancer mutation, reminds us that ‘bad’ genes come along with the patient, and that clinicians should thus acknowledge and care for the patient rather than the disease. (p. 37)

As Dr. Klitzman admits, the data provided in the book may not be wholly generalizable, as it pertains to a small set of people in a specific location (p.19). However, the book draws a general picture of the personal, social and institutional struggles faced by those who are, or may be, affected by genetic diseases, some of which being incurable. The insights will be of great interest to clinicians, bioethicists, medical humanists, policymakers, and the general public. Says Kay Redfield Jamison, author of An Unquiet Mind and more recently Robert Lowell, Setting the River On Fire: A Study of Genius, Mania and Character: “Dr. Klitzman lucidly discusses the moral and psychological complexities that come in the wake of genetic testing.... an important book for anyone who has the genes for pathology, which is all of us, and I recommend it highly." As do the editors of Intima: A Journal of Narrative Medicine.—Zohar Lederman

Zohar Lederman

Zohar Lederman is a medical resident in emergency medicine at Assuta Ashdod hospital and a bioethics PhD candidate at the National University of Singapore. His PhD focuses on the ethics of One Health and culling as a public health measure. His other areas of interest include: end of life care, family ethics, the dual loyalty problem, ethics of infectious diseases and public health ethics. Lederman, who served on the editorial board of Intima: A Journal of Narrative Medicine, is a contributor.

For the third time in as many weeks I’m reading Cortney Davis’s Taking Care of Time. I’m constantly jotting notes and underlining words, for every poem has a line I want to remember. I am grateful to the nurse Davis is and in awe of the nurse writer she has become. She sees under the skin of our lives, accepts and captures us in her poetry.

The first section takes Davis from practicing student to practitioner: I stabbed oranges until my hands ran with juice, then the patients until my hands ran with grace. Quickly she learns what nurses signify when we are outside of our hospital clinic setting — in the physicality of touch and embrace — but it is early in her surgical rotation where she prays as she recognizes her calling: Let this be, let this be, my life’s work.

In “Stoned,” she learns to distinguish the smell of death, unraveling it from under the smell of marijuana and hospital rooms. Driving home, a radio update on the weather takes her thoughts to the rise and fall of the body’s temperature until she collects herself — the weather — she says out loud — - the weather. That’s all.

It may be in the woman’s clinic where Davis truly loses her heart, as she receives her young patients. She sees beyond the narrow mouth of a vaginal speculum and the reach of her hands cupping a budding uterus, while hearing the nervous words and beating hearts of her young patients, who come to her with their anxious mothers hovering beside them and the fluttering hearts of their unborn babes to the fears they carry:

I reach up, enfold her hands.

I too had to learn that my body was mine.

And then a sharp one-movement poem, as Davis becomes the patient. Now Davis learns another level of loving. In her deepest pain, she understands gender:

How necessary both -

The tender gentle sympathy

and at other times

The strength and deference

that lifted and held and did not let me fall.

We witness the beloved care of the nurses, in juxtaposition to the teaching residents, each one smacking the hand sanitation device, as they abandon her.

I’m not sure Davis learns to overcome the fears she finds in her patients. But it is in her poetry that she can comfort them, herself and us. In “On Call: Splenectomy,” she writes:

I’ve taken Pity on you

left out the really awful part . . .

And these stories

How I tame them on the page.

These are Davis’s gifts, the stories that she has plucked from her life’s work. Now, in these terrible frightening times, we draw comfort from Davis’s poems, knowing she has received us. She has heard our stories and our cries, returned them to us, wrapping her words to in poems.

Here they belong to you, she seems to say. We receive them with gratitude.—Muriel A. Murch

Cortney Davis, a nurse practitioner, is the author of Taking Care of Time, winner of the Wheelbarrow Poetry Prize (Michigan State University Press, 2018). Her poems "Entering the Sick Room" and "It Was the Second Patient of the Day,"appear in the Fall 2018 Intima: A Journal of Narrative Medicine. Learn more about her work at cortneydavis.com

Photo by Jon Gordon.

Muriel A. Murch was born and grew up England, graduating as a nurse in 1964. In 1965 she married Walter Murch in New York City, and they motorcycled to Los Angeles, relocating to the Bay Area in 1968. Murch has a BSN from San Francisco State in 1991, completing her book, Journey in the Middle of the Road, One Woman's Journey through a Mid-Life Education (Sybil Press 1995). Her short stories and poetry are included in several journals, including most recently, Stories of Illness and Healing, Women Write Their Bodies (Kent State University Press 2007); The Bell Lap Stories for Compassionate Nursing Care (CRC press, Taylor and Francis 2016); and This Blessed Field: How Nursing School Shaped Our Lives and Careers (Kent State University Press 2018). Her work is included in the anthology Learning to Heal, Reflections on Nursing School (Kent State University 2018). Discover more about her work at murielmurch.com.

Imagine a medical student lingering outside the door of the anatomy lab, half eager to enter and yet half afraid. When she opens the door, the student will enter a place Danielle Ofri, MD, calls "Stuffy, smelly, drippy, disgusting" in her introduction to this beautifully conceived and presented volume entitled Art & Anatomy: Drawings by editors Laura Ferguson and Katie Grogan, published in 2017 by the University of California Medical Humanities Press.The student might wonder how she will ever survive learning to dissect the human body; how learn to balance the clinical and the humane; how to embrace the technical necessities while maintaining the creative passion that called her to medicine in the first place.

Laura Ferguson, Artist in Residence at New York University's School of Medicine's Master Scholars Program. Photo by Emon Hassan

Since 2009, Laura Ferguson, Artist in Residence at New York University's School of Medicine's Master Scholars Program, has been providing an answer to these questions, for medical students as well as for residents, physicians, nurses, and other medical personnel. On Tuesday evenings, Ferguson transforms the anatomy lab into an artist's studio, where she guides and encourages students as they study, and then draw, the beautiful bits and pieces of the human body.

The purpose of her Art & Anatomy seminar, Ferguson writes, is not for students to create perfect art but rather "to experiment, to take risks" (page 134). Here there is no right or wrong, only the opportunity to look deeply and experience the human body artistically.

The drawings in this book are intimate, sensual, and astoundingly gorgeous, presented in an order that reflects the eight sessions of the course. In session one, students each select a bone from the "bone box." Ferguson names the bones, shows where they articulate in the human skeleton, then invites students to study and draw their chosen bones, the whorls and dips. As they draw―vertebrae and spinal column, the drama of sacrum and pelvis, ribs, femur, the tiny bones of the foot―students learn forms that fascinate rather than facts to memorize.

Editor Katie Grogan. Photo by Jeff Weiner

Ferguson also asks students to draw the bones of their own hands, to imagine bone linked to muscle and tendon, and perhaps to ponder how their anatomy is like or unlike that of their patients. Hannah Bernstein, on page 60, draws her left hand from without and within, including a scar that ladders down from the base of her thumb. Amy Ou draws her hand holding the hand bones of a skeleton (page 67), surely a way to connect her own living flesh with the reality of patient mortality she will encounter during her medical practice.

Storytelling is encouraged. Jing Ye draws the pelvis with a fibula and radius intersecting, naming this "The Fiddler" (page 43). Shian Liu, titles the ribcage, drawn in strong strokes, "Ribcage, of Breath and Bone" (page 35). Karen Ong draws a cadaver in its protective bag, naming it, "Under My Skin" (page 106). Such storytelling encourages students to visualize the lives of their patients and to examine their own emotional responses to these imagined lives.

In another session, students draw from life models, a chance to see the body both in motion and repose and so picture the movement of bone and muscle under skin. Students also draw from cadavers, an artistic and emotional challenge. Encouraged to observe in groups, students focus on details―not an easy task when faced with the lovely complexities of the opened body. In later sessions, students become even more intimately involved with the cadavers, removing individual organs to visualize their precise locations in the body and to observe the natural variations in human anatomy. Studying the organs they removed, students discover beauty in kidney, lung, heart, or brain. Some choose to draw the faces of their cadavers. Yohei Rosen's becomes a study in the planes and angles of the face (page 108); Michael Malone's "Bisected Head" is titled "Abandon" (page 115).

In the final session, students put finishing touches on their drawings and select which to scan and save. Many of these drawings have found a home here, in this fascinating and moving book. As Ferguson's students surely must leave her Art & Anatomy drawing class changed and inspired, so too readers will be intrigued and humbled by these accomplished and deeply reverent drawings.—Cortney Davis

Cortney Davis, a Nurse Practitioner, is the author of Taking Care of Time, winner of the Wheelbarrow Poetry Prize (Michigan State University Press, 2018). Her other poetry collections include Leopold’s Maneuvers, winner of the Prairie Schooner Poetry Prize, and Details of Flesh (Calyx Books). Her non-fiction publications include When the Nurse Becomes a Patient: A Story in Words and Images and The Heart’s Truth: Essays on the Art of Nursing. Davis is co-editor of Learning To Heal: Reflections on Nursing School in Poetry and Prose (Kent State University Press 2018). She has received an NEA Poetry Fellowship, three CT Commission on the Arts Poetry Grants, and is an annotator for the NYU Literature and Medicine Database. “Entering the Sick Room” and “It Was The Second Patient of The Day” (Poetry) www.cortneydavis.com @nurseprofile

“A schizophrenic is no longer a schizophrenic…when he feels understood by someone else” reads the epigraph on this quietly powerful book of poetry by pediatric nurse practitioner Katherine DiBella Seluja. The words come from Swiss psychiatrist and psychoanalyst Carl G. Jung and introduce the reader to the emotional heart of the book, which movingly reflects the facets of the writer’s life, as a clinician, poet and understanding sister to a brother named Lou who lived with schizophrenia and substance addiction.

The slim volume, published by the University of New Mexico Press, is divided into four sections: Time Travel; Free Concert; Sing to Me; and Stars Speak. Each section starts with a short free-form prose poem in an imagined voice, perhaps that of Lou’s, drawing a vivid visual tableau. In terms of overall structure, the book has a narrative arc that spans from childhood through adulthood, from beginnings to endings. Some poems are tales of families and communities dealing with mental illness in everyday life and in startling moments of illness and death. Throughout, Seluja, whose poem about Parkinson’s, “Not Every Homemade Thing,” appeared in our Spring 2017 issue, brings her vivid language, compassionate affection, deeply-felt visions and clinical observations into poems that transport readers close to the tragedies and the moments of inspiration, as well as the experience of grief and acceptance, as she receives and perceives them.

One of the most original and skillful aspects of this collection is that we hear more than the poet’s voice on these pages: Seluja has said that Gather the Night includes “prose poems and persona poems that express the voice of psychosis, the voice of addiction and Lou’s imagined voice.” While each poem stands solidly on its own, reading from beginning to end increases the intensity of the connection with the people, places and things in it. In Time Travel, for instance, we see neighborhoods and neighbors, some sly and seductive (Reynaldo in “Chiquita”) and some down-to-earth and welcoming (Scottie, the grocer and Mrs. Gratzel, the baker’s wife in “Local Grown.”). We see the pummeling a sister gets from a brother in the name of karate practice in “Kata,” or the way a mother delivers bad news in “Storm Hymn”:

One thin crack in the plastic sign

on the locked ward door

Winds its way through

Authorized Personnel Only

like a branch of the Hackensack River

where we used to play.

Dried mud thick on our shoes

split in so many places,

our mother’s face when she said,

We just admitted your brother;

he told us his crystals were melting.

Waiting for the orderly to turn his key

I turn back to our winter childhood refuge

under the cellar stairs.

We were base camp

guardians of snow

charted drift and temperature

graphed hope for Sunday night storms.

Now gray clouds

and Thorazine doses increase,

he wanders the blizzard alone

no guide rope tied to the door,

unique as each stellar dendrite

no two of him alike.

Along with the concrete, graceful imagery of the poems, we also receive information about illness and madness—and how the clinical world handles it, especially in the second section, Free Concert. We hear from a doctor in “The Psychiatrist Said” (“It’s [the schizophrenia] all a matter of proteins/We’ll have it cracked in three to four years”), while we glimpse inside a medical facility in “Spinning with Thorazine.” We witness Seluja’s ambitious way of contemplating and confronting the big-picture issues of care in poems such as the ironic “The History of Healing” (“It began as a huddle of knowers, passed through oral tradition/those who could ‘heal’ and those who at least attempted”). The chilling “When Your Son is Diagnosed in the 1960s” notes an earlier era’s method of treatment and causes (“His psychosis is tied to your mothering/and it’s time to cut the chord, be careful of the sting”).

Katherine DiBella Seluja

Throughout it all, we get to know her brother Lou, a musician whose mandolin is elegantly described in “She Wore Opals at Her Neck” (“He fell in love with the mahogany curve/her hip and polish/the rosewood waist/and the way her neck fit to his palm”). Seluja expresses not only the affection and love she feels for him but also the wounds and wreckage that comes from a closeness with someone experiencing schizophrenia. There’s a complex layer of emotions at work here, that spans from caring and fearful to raging and raw, especially in the short “Telephone, 4 a.m.” where the resignation and anger in lines like “What if there were a box to keep him in/somewhere to store him away/to bring out with rainy weather/Then you’d have time to listen, unravel every line” comes through. In many of the poems in the Sing to Me third section, we intensely feel the frustration and fear for a loved one in peril.

In the final section, Stars Speak, poems turn elegiac, mourning Lou’s death. Again, the poet displays a skillfulness is accessing and expressing the complexity of emotions that accompany the death of a sibling. In “News of a Brother’s Death,” we feel the matter-of-fact reality of it (“Don’t kid yourself/it’s nothing like a movie”) while “Wanderlust” explores the way that Lou lives on in the tiny details of a life (“Find me/in the weave of my brother’s shirt/in the tread of mud on the floor”). Seluja mines sadness and strength in startlingly beautiful poems, “Here Among the Ruins” and “If You Need a Wall.” And it feels as if she’s composing a way to live in the world when there’s a significant loss in “Do Our Ancestors Listen When Called” that ends:

My heart is occupied with the ones I’ve lost, each with its own

celestial sphere, their pulse echoes the meridian.

I keep rearranging you like a favorite satellite, dragging you

into good orbit, your solar panels deployed to the stars.

Gather the Night ambitiously takes on the task of speaking about loss, addiction, madness, grief and love, bringing us into its intimate confrontations. We emerge from reading it with a deeper understanding of all of the above, a sense of wonder at the way we get through the harder, harsher aspects of our lives, and an appreciation for poets and nurses like Seluja who guide the way.—Donna Bulseco

Donna Bulseco, MA, MS, is a graduate of the Narrative Medicine program at Columbia University. After getting her BA at UCLA in creative writing and American poetry, the L.A. native studied English literature at Brown University for a Master's degree, then moved to New York City. She has been an editor and journalist for the past 25 years at publications such as the Wall Street Journal, Women's Wear Daily, W, Self, and InStyle, and has written articles for Health, More and the New York Times. She is Managing Editor of Intima: A Journal of Narrative Medicine.

One powerful and widespread result of the narrative turn in academia has been to challenge what constitutes knowledge and to assert narrative as a particular type of valuable knowledge across a wide array of fields, including the study and practice of medicine. Narrative “knowledge provides a rich, resonant comprehension of a singular person’s situation as it unfolds in time, whether in such texts as novels, newspapers, stories, movies, and scripture or in such life settings as courtrooms, battle-fields, marriages, and illnesses” (Charon). Embracing narrative knowledge in the context of health communication, editors and authors Jill Yamasaki, Patricia Geist-Martin, and Barbara Sharf have contributed a unique text for students and healthcare professionals and practitioners entitled Storied Health and Illness: Communicating Personal, Cultural, and Political Complexities.

Innumerable textbooks, topical books, journal articles and the like have been written about the role of communication in health, from the medical interview to the mass-media driven public health campaign, which will whet the appetite of anyone interested in the broader field of health communication. However, Yamasaki, Geist-Martin and Sharf approach health communication through a narrative lens, and the subsequent outcome is a very different voice among the crowd of health communication texts crying out to be read.

Each chapter of Storied Health and Illness begins with a health narrative, such as the miscarriage story at the outset of the chapter on breaking bad news. The narrative functions as a way to illustrate the health communication concepts, theories, topics, and complexities covered in the chapter but also underscores narrative as a way of knowing for the reader. The book begins by introducing what a narrative approach to health communication means. More topical chapters follow, tackling narrative approaches to patient-provider interactions, healthcare teamwork, digitized healthcare, the role of art in healing, workplace health, stigmatized health experiences, breaking bad news, caregiving, supportive communities, social support, health campaigns, entertainment health education, politics of healthcare systems, health disparities, and activism. With broad strokes, the reader is introduced to narrative approaches to wide-ranging health communication topics and concerns that can, at the very least, inform and, at the very most, transform the practice of medicine and health communication.

Of particular interest are the chapter authors’ acuity at deconstructing the more traditional approaches that eschew narrative without destructively dismissing the value of alternative approaches. In most cases, the authors are attentive to the application of narrative knowledge within the appropriate health context to not only build knowledge but to affect practice. In particular, Dutta and Kaur’s chapter on the culture-centered approach and health disparities provides a constructive means to address health disparities using narratives that are “situated at these intersections of culture, structure, and agency”. Through communicative inversions — the intentional, strategic use of storytelling to voice and reflect what is often the oppositional experience of the storyteller to the collective understandings — stories take on a transformative power to address health disparities, possibly from a community participatory response. Similarly, Sharf demonstrates through diagrams how patient narratives intersect with four continuums: centrality of illness, changeability of outcome, engagement with illness, and patient-provider collaboration. Such practice-based knowledge is peppered throughout each chapter, making this text both generally informative for a reader who knows little of health communication and specifically helpful to a health practitioner or scholar wanting to diversify his or her narrative repertoire.

Scholar Lynn Harter reminds us that “narrating is a central feature of communication between care providers and patients, in relationships realized in health organizations, and in the mediated world of health-related information and entertainment.” Such a reminder reverberates in the approach, content, and lessons learned from Yamasaki, Geist-Martin, and Sharf’s text that take the reader into, through, and beyond the clinical encounter to interrogate how narrative and health intersect.—Elizabeth Spradley

Elizabeth Spradley is an assistant professor at Stephen F. Austin State University. Elizabeth completed her Ph.D. in health communication at Texas A&M University in fall 2013 and has embarked on an academic career aiming to blend interests in health communication, narrative, and interpersonal relationships. In addition to working on several research projects and teaching courses in interpersonal and health communication, she is passionate about growing her own food, encouraging others to garden, and speaking about her faith.

"Draw Stronger" is a new book that helps artists, writers and others methods for self-care.

Cartoonist, educator and Intima contributor Kriota Willberg creates graphic medicine artwork that deals with healthcare and illness in cleverly insightful ways. We look at her work that makes us laugh as we're thinking about the sensitive issues she brings so forcefully into view—like the ambiguity of a "Do Not Resuscitate" order ("Frankenstein," Intima, Fall 2017) or the thoughts of a therapist about her patient during a deep tissue massage ("Friction,"Intima, Fall 2015). As the first-ever artist-in-residence at the New York Academy of Medicine Library, Willberg brings her infinite knowledge of the human body with its attendant joys and woes into clear view in her art, offering an engagingly humane perspective on how it feels to be human.

Her useful and entertaining new book, "Draw Stronger: Self-Care for Cartoonists & Other Visual Artists," published by Uncivilized Books, takes her sense of mission into a more practical realm, one of explaining the many aches, injuries and strains our bodies suffer during our daily activities. Common complaints such as muscle spasms, tendon injury and nerve entrapment are explained in clear, humorous illustrations, so we understand exactly how these dreaded damages occur, and once we can see and understand their origins, Kriota Willberg gives us the ways to counteract them. She asks us to think about our pain and how we describe it, deny it or treat it—her book is a call for us to consider the benefits of self-care as well as a how-to manual for the ways to go about it.

Although the book's title pointedly calls out to those hunched over a drawing table, I suspect that many of us can relate to the bodily pain described—and indeed, should read and follow her well-laid-out prescriptions for fixing and preventing the types of injuries also caused by repetitive activities such as computer work or posting videos of cute kitties on our smartphones.

"Self-care is important!" she lightly admonishes us in her chapter entitled, "Think like a Cartoonist-Athlete" and as readers, we're probably giggling while we're following along with just how to do that as we read on to the next chapters, "Live like a Cartoonist-Athlete," and "Train like a Cartoonist-Athlete" where she demonstrates the many ways "to modify our daily activities to reduce the change of injury 24/7."

Particularly useful are her illustrated exercise chapters for different parts of the body, from the hands and wrists, to exercises for the neck, chest and shoulders and finally, workout routines to resolve the mother-of-all-pain part of the body, the back. What's appealing about her instruction is that it comes in the form of her amusing illustrations with accompanying commentary from a jagged-lightning bolt wise-guy that reminds the reader of those sharp jabs we experience when our bodies have been under stress.

What makes "Draw Stronger" different from other self-help books is Willberg's sense of humor that infuses every drawing, tip, fact, exercise and quip with originality and a lightness of being. While there will be pages you'll want to photocopy and tape up near your computer or sketch table for easy reference and reminders to stretch throughout the day, the book will also be a useful reference guide whenever a lightning bolt of raw pain shoots up your arm, neck, or back. —Donna Bulseco

"The Serpent's Secret" is the first book in the Kiranmala and the Kingdom Beyond Series; Scholastic publishes the book on February 27, 2018.

“Stories are the way we human beings shape our worlds,” writes Sayantani DasGupta, MD MPH, in the article “Stories Matter: Narrative, Health and Social Justice.” In the piece, the author, educator and Intima contributor (Spring 2016 issue), elaborates on the ways that narrative is shaped by many factors, from the personal to the political. Narrative, she posits, can be life-changing: “In the face of illness or adversity, injustice or trauma, stories help bridge what theorist Arthur Frank has called ‘narrative wreckage’—the point at which one’s old life’s plot is no longer valid, and one needs a new plot with which to continue life’s journey.”

These words have a particular resonance right now in light of the #metoo movement, where long-silenced voices are being heard in narratives that support finding ways to balance sexual inequality. Curiously enough, the words are equally significant as a way to read “The Serpent’s Secret,” a remarkable and delightful new work of children’s fiction by Dr. DasGupta, just published by Scholastic as Book 1 of the new series Kiranmala and The Kingdom Beyond. How refreshing to find an electrifying social theorist like Dr. DasGupta who is also an entertaining prose stylist able to deliver an empowering novel for tweens. It’s a book that is multi-generational in the way the Harry Potter and Hunger Games series were—"The Serpent's Secret" also speaks to readers who finished middle school many red moons ago.

The book begins on the morning of New Jersey kid Kiranmala’s birthday, who in her own sassy voice introduces her story about a day when everything in her world radically changes:

The day my parents got swallowed by a rakkhosh and whisked away to another galactic dimension was a pretty crap-tastic day. The fact that it was actually my twelfth birthday made it all that much worse. Instead of cake or presents or a party, I spent the day kicking demon butt, traveling through time and space looking for my family, and basically saving New Jersey, our entire world, and everything beyond it. But I’m getting ahead of myself. I’ll tell you that part soon. First, let me back up a little.

As readers we are engaged by this smart, empowered narrator, who is alone, newly orphaned, yet tough—she already sounds like Ripley of Alien, one of the original female butt kickers in 1979 when the sci-fi thriller came out. We’re intrigued by words we do not know (what the heck is a ‘rakkhosh’?) and are drawn in by the promise of time travel and life-challenging adventures in other galaxies. In her own knowing way, young Kiranmala has given us the big-picture plot in the first paragraph, enticing us to come along with her to see what transpires.

Like many of the best books in children’s fiction, parents are dispensed with from the get go, here swallowed by a rakkosh—a “carnivorous, snot-trailing demon” who populates many of the Bengali folktales Dr. DasGupta was told as a child. In the first chapters, Kiranmala’s childhood home is also trashed by the demon with a black tongue who she calls “halitosis head.” That’s the overall dynamic and tone the author sets up: sword fighting amid the silliness, cleverness cancelling out the fearful chaos.

“The Serpent’s Secret” is aimed at young people who are at an age where childhood and adulthood begin to overlap, where the power of parents is displaced by the power of peers. Dr. DasGupta, a pediatrician and a mother, knows only too well the rough road of this developmental stage, when the plot of childhood branches off into new paths toward adulthood, and as a skillful writer, she’s able to bring to life the joys, confusion, real terror and pure happiness that emotional journey often takes in intriguing and amusing—not heavy-handed—ways. We are inside the young narrator’s head, seeing and judging events from her no-nonsense point of view. Her voice is compelling.

In Kiranmala’s quest to save her parents, she meets up with a cast of eccentric characters as amusing, complex and memorable as the flying monkeys, the Scarecrow, Tin Man, Good Witch and Bad Witch that Dorothy encounters in “The Wizard of Oz.” There’s Lal and Neel, two brother princes on winged horses who battle zombies and escort Kiranmala from Parsippany to the Kingdom Beyond Seven Oceans and Thirteen Rivers in search of her parents. There’s the magical pun-loving bird, Tuntani, whose corny jokes provide lighthearted moments and reflect the goofiness (“How do chickens get strong? Egg-ersize!”) tweens and teens love. There’s the intimidating green-eyed Sesha, the Serpent King, “guardian of the primordial ocean of divine nectar, keeper of time” and many others, each one an encounter for Kiranmala to confront and conquer to get to her goal.

Throughout the story, Kiranmala discovers dramatic truths about her origins as well as several revelations about life. There is the conflict between dark and light, a familiar theme in children’s and YA fiction from Grimms’ Fairy Tales to “A Series of Unfortunate Events” and “Twilight.” In “The Serpent’s Secret,” Kiranmala learns the difference between dark energy and dark matter, passes through tides of rubies in a peacock barge that reroutes her to the Demon Land (aka "The Blood-Thirsty State,") and battles a room of pythons to steal a jewel needed to read a shape-shifting map that will guide her to her parents. Those are just a few of the startling and original moments that keep the narrative taut and surprising throughout the novel’s 338 fast-paced pages.

Sayantani DasGupta, the daughter of Indian immigrants, wanted to share her love of books with her own kids but was saddened by the lack of heroes that looked like her family and neighbors. She decided to write her own stories, returning to the folktales she heard on childhood trips to India.

In the Author’s Note at the end of the book, Dr. DasGupta goes into detail about the Bengali folktales that inspired many of the characters in “The Serpent’s Secret.” It’s a short and welcome postscript that underscores one of the reasons the author decided to write children’s fiction. As the daughter of Indian immigrants, she wanted to share her love of books with her own kids but was surprised by the lack of diversity in the books available. She decided to write her own stories, returning to the folktales filled with bloodthirsty demons and enchanted animals that she heard on childhood trips to India. Cue applause for that decision: In the first book in the Kiranmala and The Kingdom Beyond series, Sayantani DasGupta has created lovable characters, a rollicking narrative and meaningful themes that have a broad appeal for many young (and not-so-young) readers, setting up a thirst for what's up next for the appealing young heroine.

New fans of Princess Kiranmala will undoubtedly be clamoring and drooling like rakkhoshs for Books 2 and 3.—Donna Bulseco

DONNA BULSECO, MA, MS, is a graduate of the Narrative Medicine program at Columbia University. After getting her BA at UCLA in creative writing and American poetry, the L.A. native studied English literature at Brown University for a Master's degree, then moved to New York City. She has been an editor and journalist for the past 25 years at publications such as the Wall Street Journal, Women's Wear Daily, W, Self, and InStyle, and has written articles for Health, More and The New York Times. She is Managing Editor of Intima: A Journal of Narrative Medicine.

She is 7. She is small…yet she fills the entire room…this child…has been raped... But she is still sturdy, she still smiles…this child of 7 is a giant, a superhero."—Social worker Kristen Slesar, writing about a young client

“My mother and I are on our way to the store. A gnome, dressed in curly-toed shoes, striped stockings, and pointy cap, waits on the sidewalk. He tries to pinch me. My mother cannot see the gnome. I try to hide, wrapping myself in her skirt…”—Social worker Lynne Mijangos, describing a dream she had

In some chapters, the social workers describe how they have developed and used narrative interventions with a wide range of individuals, families, and groups facing a variety of life challenges. In others, they share how they have turned their narrative skills inward and used them to deepen their self-understanding. In each instance, they use the tools of narrative training—close reading, attentive listening, reflective writing, and bearing witness to suffering —to help themselves and others confront and overcome external and internal barriers.

In one chapter, social worker Lauren Taylor uses psychotherapy and oral history to help clients find deeper meaning in their lives. Taylor describes her work with Marvlous, an African American woman who is depressed and in pain. As they talk, Taylor realizes that this sharp 95-year-old is a living historical archive. Working together, Taylor helps Marvlous, who at first thinks she has nothing much to say, recount and preserve the story she and her ancestors played in African American history. Taylor also describes her work with Joe, a 68-year-old man who is contemplating suicide. In the course of their work, Joe, who always dreamed of becoming an actor, writes and performs in a triumphant one-man show about his life.

Demonstrating the cross-border potential of narrative medicine, Benaifer Bhada talks about the narrative work she did with HIV-infected truck drivers in Kenya, and how participation in the group helped the men overcome feelings of shame and isolation, enabling them to seek appropriate treatment.

What do these stories have in common? In eloquent fashion, they all demonstrate how sharing our stories can help us break out of isolation and find our voices and our communities—at every stage of life —even as our bodies and cognitive abilities begin to deteriorate. Working with adults with dementia, Mary Hume uses poetry, co-constructed by the group, to express themselves, affirm their own value and continue to participate in their community:

Some readers will want to dip in and out of these stories, which will give them a sense of the benefits of narrative practice in social work. But once one starts reading the stories, it's hard to skip around and instead read straight through. Each story is rich in its unique details and emotional truthfulness, making the book hard to put down.—Nelly Edmondson

NELLY EDMONDSON is a graduate of the Narrative Medicine Master's program at Columbia University. She also is an award-winning editor and writer with extensive experience covering medical topics for print and online outlets. In addition to serving as a staff editor at publications such as Weight Watchers Magazine and Ladies’ Home Journal, she has written articles for the The New York Times, Parents, MAMM Magazine, as well as medical-school websites and publications such as Einstein Magazine and The Chironian. http://www.nellyedmondson.com

It's that kind of startling detail, one remembered and deeply felt, that stands out in this medical memoir. In many ways, the author followed the normal trajectory of a clinician's path: After growing up in Cleveland, and excelling in school, Dr. Stidham attended Notre Dame and the Medical College of Ohio. In the 1970s, he was a fellow at Johns Hopkins, which had one of five Pediatric Critical Care training programs in the country. What starts to emerge in the narrative is Dr. Stidham's heightened sense of purpose: He went on to establish a pediatric palliative care program, the first in the region, at LeBonheur Children’s Medical Center hospital in Memphis, where he spent twenty-eight years of his career.

Encounters with critically ill and dying children and their parents present the poignant “sudden intimacies” of the book. The “blessings” of the title refer to the young patients, families and healthcare personnel who touch him. But they are also more broadly defined, as when Dr. Stidham writes about his early career, that “without that training and the opportunity to gain [pediatric critical care] expertise I would not have had the adventures that blessed the rest of my life.” The book is just as much about his personal as his professional life, and he says the two are “inextricably intertwined.” This is reflected in the structure of the book, which moves around in time and ranges wide geographically. We are taken on hiking trips to Colorado, camping trips in Arkansas, to Nicaragua where he helped set up a pediatric cardiac surgery program, and to Kingston, Ontario where he moved late in his career.

Dr. Stidham frankly relates his own marital and health problems, numerous enough to raise the question of how much his personal life suffered from the professional toll of long hours, nights on-call, and the emotional strain of dealing with dying children and their families, a potential conflict he doesn’t address directly. Instead he conveys his belief that life is extraordinary, and that he has done unusual and extraordinary things with his. He maintains an optimistic world view, a mindset that gives him the empathy and strength needed to sustain a long medical career.

Dr. Greg Stidham

Blessings and Sudden Intimacies makes you think about what you’ve done with your life, yet somehow Dr. Stidham leaves you feeling that whatever you’ve done, it’s enough. He writes with disarming charm: “Every life is rich in its own unique way, and deserves commemoration. Perhaps it is, in part, for those others that I write, for their rich, but otherwise uncommemorated lives.” He certainly conveys the richness of his own.—Priscilla Mainardi

PRISCILLA MAINARDI, a registered nurse, attended the University of Pennsylvania and earned her MFA degree in creative writing from Rutgers University. Her work appears in numerous journals, most recently The Examined Life Journal and Prick of the Spindle. She teaches English Composition at Rutgers in Newark, New Jersey. Her short story “Pretending Not to Know” appeared in the Spring 2014 Intima. She joined the editorial board of the Intima in 2015.

In Hugh Aldersey-Williams' Anatomies: A Cultural History of the Human Body (W. W. Norton & Company, 2013), he poses a quasi-cultural, and intentionally un-anatomical, rationale for his constant middle of the night urination troubles: he’s getting old. The book does not offer a detailed glimpse into any specific disease, nor does it follow any individual navigating through a disease process. However, Anatomies allows the reader, regardless of training or background, to enjoy humorous anecdotes that explain how our cultural interpretations of our bodies, and what disease can do to them, have been shaped for centuries.

Aldersey-Williams makes known his disdain for doctors’ predilection to use overly obtuse medical definitions for body parts, like saying coxa for hip. He flexes his wit and knowledge on some of the most complex of organs while seamlessly jumping from micro to macro levels of anatomical and cultural understanding.

While tackling the larger questions that researchers continue to disagree upon, such as what constitutes an organ, the author also poses questions mystifying and ridiculous in equal parts, asking how we join many other species in the act of grooming yet we are unique in our development of hairstyles. He allows you to draw from the experiences he has accumulated as a field researcher as he reports drawing limbs and organs from the formaldehyde confines of an anatomy lab, to sketches of live subjects, and onto the assessment of dancers’, and our own, physical limits.

The book, much like a textbook sitting on the edge of a cadaver tank in the anatomy lab, is broken up by region and body part. When read through continuously, this layout can prove to be a little disjointed, but the separation of topics allows for a seamless re-entry into the text after prolonged periods of interruption. Anatomies will hardly provide direct insight into any one area, but opens avenues of thought into how we perceive ourselves, each other, and the most famous around us.— Salvatore Aiello

Salvatore Aiello M.S. is a medical student at Chicago Medical School at Rosalind Franklin University. After graduating from University of Michigan, he found that his minor in writing had the most lasting utility in both his academic and creative pursuits. Salvatore has several scientific articles published in peer-reviewed journals and has contributed to the blog, In-Training. Beyond his coursework and writing, he is described as the Benevolent-Overlord of the Medical Humanities Club where he works with his colleagues to promotes resiliency in physicians and all healthcare professionals.

"Organ transplantation always results in a crossing of paths: there is a life that ends and another that regains vital energy: hours of anguish and despair on the one hand, of apprehension and joy on the other. A cruel but inevitable crossing." These are the words of Dr. Paolo Montalto, a gastroenterologist who graduated from the University of Florence's Medical School after studying at the Hepatobiliary Unit of the Free Hospital in London.

“Nothing so concentrates experience and clarifies the central conditions of living as serious illness,” wrote Harvard psychiatrist Arthur Kleinman, and nowhere is that idea more evident than in a new memoir entitled, The Bright Hour: A Memoir of Living and Dying (Simon & Schuster, 2017) by Nina Riggs.

An accident sets off the events of Sara Baker’s novel The Timekeeper’s Son (Deeds Publishing, 2016), landing one character in the hospital. Ms. Baker, whose story “The Sun in Cannes“ appeared in the Spring 2015 Intima, weaves together the voices of numerous characters whose lives become entwined by the accident.

An Iraq veteran fighting the “quiet conflict” of PTSD, a woman with memory loss who hides her disability as well as her misery, a man whose traumatic brain injury helps him make sense ofhis brother’s disability. These are a few of the many voices we learn from in Barriers and Belongings.

At first glance, the book is a disabilities studies textbook with an introduction and chapter openings that provide background on social and cultural approaches to disability, as well as useful definitions. But Barriers and Belongings is much more than a textbook: it’s an eye-opening collection of lives, told with honesty and moving candor. The narratives, which are organized into sections around themes such as communication, family and relationships, are engaging and short, allowing room for many different points of view. Most are written from the perspective of early adulthood, reflecting back on growing up, which gives them an appealing coming-of-age quality. The writers lead us up to the moment their conception of their disability changes in some way. The ways are as varied as the disabilities themselves, which range from acquired conditions such as PTSD and chronic pain, to congenital conditions such as cerebral palsy and Down Syndrome, to mental health and cognitive conditions. Because of these many viewpoints, one writer identifies the need for “people with diverse disabilities [to] recognize our common struggle” in order for the disability movement to reach its “full potential to change society.”

For the book is as much about the larger society as it is about the individual stories. Most of the writers see disability not as a problem to be solved but as an integral part of themselves, and want to reframe disability from a nonsocial and nonmedical perspective. As one writer puts it, “I wonder how the world would be if everyone realized that normal didn’t exist, and that trying to achieve normalcy was futile. What if disability didn’t always need a cure? What if everyone equated disability with difference, not deficiency?” Or as another writes: “Sometimes, abnormal is normal.”

PRISCILLA MAINARDI, a registered nurse, attended the University of Pennsylvania and earned her MFA degree in creative writing from Rutgers University. Her work appears in numerous journals, most recently The Examined Life Journal and Prick of the Spindle. She teaches English Composition at Rutgers in Newark, New Jersey. Her short story “Pretending Not to Know” appeared in the Spring 2014 Intima.

No work better embraces narrative medicine than A Short Life, by Jim Slotnick. This prescient memoir, written in 1983 and published in 2014, narrates a young medical student’s terminal illness from pre-diagnosis to his final days. It is a song of life’s joys, deadly shortcuts in medical practice, the necessity of listening and paying attention, and the essential value of compassion.